A systematic review of psychometric properties of questionnaires assessing activities of daily living among older adults with neurocognitive disorders.
Alia Osman, Dennis Radman, Patricia Belchior and 1 others
PMID 39853749WHAT IT FOUND
Three informant-based questionnaires (Amsterdam IADLs, DAD, Bayer ADL) have the strongest evidence for assessing daily activities in older adults with dementia.
The Amsterdam IADLs is best for early detection of complex task difficulties, while the DAD covers the full disease continuum.
Key findings
01The Amsterdam IADLs, Disability Assessment for Dementia (DAD), and Bayer ADL Scale were the three questionnaires with the most validated psychometric properties.
02The DAD assesses both basic and instrumental activities and is the only tool among the top three that includes executive function in its assessment.
03The Amsterdam IADLs is the only questionnaire reviewed that includes items related to everyday technology use.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The review only included questionnaires available in English or French, potentially excluding valid tools from other languages. The COSMIN checklist was originally designed for patient-reported outcomes, which may not perfectly fit the appraisal of informant-based or observer-reported measures. Many included studies had methodological flaws, such as unclear statistical reporting, which lowered the certainty of evidence for several questionnaires. The authors did not contact study authors to clarify missing information, relying only on what was published.
Declared interests
None reported.
The easy way to misread this
Do not assume these questionnaires are diagnostic tests for dementia. They are assessment tools for functional performance that require clinical interpretation. Also, remember these are informant-based; they rely on the caregiver's perspective, which can be biased by their own burden or relationship to the patient.